Five risk factors (e.g., age ≥85, low functional self-efficacy) were associated with an absolute mean increase of 31.2 to 53.5 days away from home in the year after major surgery.
Cohort (n=289)
What factors are associated with an increased number of days away from home in the year after major surgery among community-living older persons?
Specific geriatric vulnerabilities, including advanced age and low physical performance, can identify older adults at high risk of spending a disproportionate amount of time in healthcare facilities after major surgery.
OBJECTIVE: To identify the factors associated with days away from home in the year after hospital discharge for major surgery. BACKGROUND: Relatively little is known about which older persons are susceptible to spending a disproportionate amount of time in hospitals and other health care facilities after major surgery. METHODS: From a cohort of 754 community-living persons, aged 70+ years, 394 admissions for major surgery were identified from 289 participants who were discharged from the hospital. Candidate risk factors were assessed every 18 months. Days away from home were calculated as the number of days spent in a health care facility. RESULTS: In the year after major surgery, the mean (SD) and median (interquartile range) number of days away from home were 52.0 (92.2) and 15 (0-51). In multivariable analysis, 5 factors were independently associated with the number of days away from home: age 85 years and older, low score on the Short Physical Performance Battery, low peak expiratory flow, low functional self-efficacy, and musculoskeletal surgery. Based on the presence versus absence of these factors, the absolute mean differences in the number of days away from home ranged from 31.2 for age 85 years and older to 53.5 for low functional self-efficacy. CONCLUSIONS: The 5 independent risk factors can be used to identify older persons who are particularly susceptible to spending a disproportionate amount of time away from home after major surgery, and a subset of these factors can also serve as targets for interventions to improve quality of life by reducing time spent in hospitals and other health care facilities.
Gill et al. (Fri,) conducted a cohort in Major surgery in community-living older persons (n=289). Risk factors (age ≥85, low SPPB, low PEF, low functional self-efficacy, musculoskeletal surgery) vs. Absence of risk factors was evaluated on Days away from home in the year after major surgery. Five risk factors (e.g., age ≥85, low functional self-efficacy) were associated with an absolute mean increase of 31.2 to 53.5 days away from home in the year after major surgery.